Provider Demographics
NPI:1821233990
Name:LEWIS, LAUREN FAITH (CAS #7370)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:FAITH
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CAS #7370
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 MACARTHUR BLVD STE 12
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-5260
Mailing Address - Country:US
Mailing Address - Phone:510-568-2432
Mailing Address - Fax:510-568-3912
Practice Address - Street 1:10700 MACARTHUR BLVD STE 12
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5260
Practice Address - Country:US
Practice Address - Phone:510-568-2432
Practice Address - Fax:510-568-3912
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAS7370101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-1702064OtherOUTPATIENT DRUG/ALCOHOL